When it comes to healthcare in Ireland, the news isn’t good. The headlines in the papers and the television news reports are ripe with exclamations of how badly the system has broken down in recent years. Stories of patients waiting for beds, tests and appointments are featured daily in the Irish media.

As someone who has no private health insurance here, my own experience has been quite good. For 50 quid I can see my general practitioner and she’s available with one or two days’ notice. My prescriptions cost about 10 euro on average. Of course I have never needed emergency hospital care – which according to the news reports is a whole different story all together – until recently.

Last week I went to my GP complaining of chest pain, rather a tightness in the middle chest area, for the previous few days. She surmised it was likely esophageal spasms caused by an upsurge of stomach acids. While I was there she took my blood pressure, which was surprisingly high; I’ve always had perfect readings and my last check was only a few months ago, also perfect. She prescribed meds for the spasms and told me to come back in a few days. When I returned with the same symptoms and high blood pressure, she sent me to the emergency room at Beaumont – a public hospital in Dublin.

And that’s where I got my first dose of the reality that is public healthcare in Ireland.

Because chest pain is something that is typically considered serious, I was actually seen relatively quickly by the nurse. She took my vitals and sent me back into the waiting room, where I sat with Mountaineering Man. There were a good number of people there, some with visible injuries and some without, but the atmosphere was relatively calm. There was one man who moaned out loud every five minutes, but otherwise it wasn’t a terrible place to be.

Once I got called into the urgent emergency section, it was a different story all together. I had to leave MM – they wouldn’t let him come in with me – so I told him to just go home as it looked like I’d have quite a long wait. The area that I had to sit in was just behind the larger emergency room, which looked like a war zone. There were gurneys everywhere – so many that I had to wiggle my way in between them to get past. The patients in that room were suffering; some had bleeding head wounds, others had swollen stomachs and one woman looked like she’d been cut quite severely in the arm. She cried out loud as I walked by.

The room smelled of urine and the loud complaining from patients was jarring. There was remnants of blood on the floor, which looked like it had been haphazardly mopped up with a dry cloth. Nurses were multitasking, many running between 4-5 patients at a time; interns tried their best to help out wherever and with whatever they could. There must have been at least 50 injured in that room, which was built for about 20 patients. “Beirut looks better than this,” I heard one paramedic say.

There were also armed gardai, who sported bullet-proof vests and guarded the one exit door. I’m not really sure why, but I assumed there was an injured criminal in our midst. Then again, there were plenty of unruly patients, some wanting to leave against doctor’s orders, others so wasted they walked around aimlessly. To say the place was chaotic would be an understatement.

Though it took a total of six hours and a second round of blood tests (thanks to a “mix-up” of bloodwork), I can’t complain about the care that I received at Beaumont. I got a chest x-ray, a heart echo ultrasound and a thorough questioning of symptoms from the doctors there. The nurses were friendly and they took care of us. At one point, a woman came round with a cart and fed us biscuits, sandwiches and tea for no charge. I was utterly grateful to see her as it’d been a good 7 hours since I’d eaten at that point.

In the end I got a proper diagnoses (swelling of joints in my ribcage plus viral infection – serious enough for meds and time off work but not life-threatening) and a new prescription. But moreover I got peace of mind, which is priceless. I can’t say that the experience was entirely wonderful…there were a lot of people suffering there who were not going to get the help they needed in a timely manner. The doctors and nurses were struggling to do what they could with the limited resources available to them. And really that’s what it comes down to, we need more resources and funds for the healthcare system – a statement that will garner me the award for Stating the Obvious!

In any case, that is my first-person account of an evening in the A&E.

African Sweet Potato Soup

Sometimes the constant dampness here in Ireland makes it hard to stay well, at least for this California girl! So I try and power up with super foods that keep me healthy but also taste great. I love this hearty African soup, which also happens to be vegan, and it’s loaded with lots of great, heart-healthy veg.

1 tablespoon olive oil

2 medium yellow onions, chopped into small dice

6 cloves of garlic, finely minced

2 medium sweet potatoes or yams, chopped into medium dice

4 carrots, chopped into medium dice

2 teaspoons ground cumin

1 teaspoon dried thyme

2 teaspoons smoked paprika

1 teaspoon turmeric

1 teaspoon Tabasco

1, 15-ounce can of diced tomato

5 cups vegetable stock

1/2 creamy peanut butter

chopped parsley and spring onion for garnish

Salt and pepper to taste

In a large soup pot, heat the olive oil over medium heat. Add the onions and cook until tender, about 3-4 minutes. Add in the garlic and cook for another minute. Toss in the sweet potatoes and carrots and all the spices. Stir and cook for about 2 minutes.

Add in the tomatoes, Tabasco and stock and stir well. Bring to a boil and then reduce the heat and cook for 10 minutes, or until the vegetables become tender. Remove from the heat.

Using a potato masher, roughly mash the soup – you want it to still have texture so just mash until it’s a bit mushy but not smooth. Place back over medium heat and then add the peanut butter; season with salt and pepper to taste. Cook for five minutes and then remove from heat. Serve with a garnish of chopped fresh parsley and spring onions. To make it a meal, top over rice or quinoa.

First of all Clare, I hope you are feeling better soon. That chest infection sounds painful! Rest yourself (really rest!).
Secondly, I’m going to go out on a limb and say that if there is still one lingering “deal breaker” about living here it is healthcare. Not to say things in the USA are perfect. But, the level of care and attention that I was used to is quite different. I dread the day something serious happens to one of us out here on the farm. The regional hospital in Limerick sounds very much like Beaumont. There were even dirty syringes on the floor when we went in with Geoffrey. I’ve heard some horror stories. Not to mention the notion that the A&E could very likely close down due to staffing which means we’d have 1.5+ hour drive to nearest ER. It’s terrifying!
Again, hope you feel improved soon.
Thanks for sharing your experience with us.
Imen x

Magda & Imen: The thing is, I was used to better care in the U.S….as someone who could afford health insurance, barely. Health insurance in the U.S. is priced at a premium, and to those who can afford it the care can be quite good. But to those who cannot, the care would most likely be subpar to that of Beaumont. People die every day in Los Angeles County Hospital waiting to be seen; that’s a fact. For me to be able to be in and out in 6 hours and pay little…that would never happen at a public hospital for an uninsured patient in the U.S. They’d be seen eventually and then receive a staggering, possibly life-changing bill in the post two weeks later.

It’s hard to say which is better, but there are good arguments on both sides.

I had no idea you’d gone through all that, but I’m glad to hear it was something that was easily treatable in the end. When it comes to healthcare here, I’m of a similar mind as you – it’s far from perfect, but at least you’ll get seen and treated (eventually), which is more than can be said if you’re uninsured in the US. When we thought semi-seriously about moving back home a few years ago, healthcare was a dealbreaker issue, but in the opposite sense of how Imen means it – as a freelancer, there’s no way I could afford it. Remind me to tell you on Friday about Matt’s trip to the A&E a few weeks ago in Sligo. 🙂

Kristin, I hear you! As a freelance journo in LA I was paying $380 per month for my COBRA insurance, which lasted only 18 months. After that it would’ve gone up to $550 for BASIC coverage, no way a freelancer could afford that! If you are a full-time, salaried employee of a company that provides health insurance, you’re golden. Otherwise, you’re screwed in the US.

Gosh, I hope you’re feeling better now Clare! A trip to A&E is not an experience I’d wish on anyone, but your points are well made re: the difference between being uninsured in the US and uninsured here. I’ve been on the uninsured side of the US healthcare system and it was a scary and (as it turned out) very costly place to be.

Assuming healthcare varies from state to state in the USA. My experience In NY and MN is that there are good programs for the self-employed. I agree that the American medical system fails patients when it comes to over ordering tests, etc, but on the flipside, here they misdiagnosed thousands of women who had breast cancer recently. I refuse to put a price on piece of mind for having excellent medical treatment (especially with a child) I agree on many of your points, but I still feel more comfortable in clean, sterile medical environments that gets it right. I am terrified to treated here for a life threatening illness. Sorry, could change, but true at the moment. Again, appreciate you sharing your candid experience Clare.

Daily Spud: Yes it’s mad to think that someone could lose their home over an emergency surgery, but that sort of thing happens in the US where the cost of healthcare is out of reach for most.

Imen: I agree, there really is no reason why hospitals cannot be kept clean, that seems the most basic of rules when it comes to healthcare (a sterile environment). And reports not being read – to me that’s sheer laziness and carelessness.

Clare, I hope you’re all better now. I’ve had experiences of both public and private hospitals in Ireland in recent years (but don’t have private insurance) and I have to say that while the public system has its merits (especially the really hard-working nurses), the difference in cleanliness is shocking. Public hospitals are squalid in comparison to private ones – I was given a blanket that was still blood-stained for my bed!

My sympathy to you Clare, it’s horrible to be exposed to such a shocking dose of reality when you’re vulnerable and alone. Yes, the health services are underfunded and overstretched. Once you get past triage, the quality of care is second to none, but up to that, it’s frightening. I’ve accompanied many members of family and friends as an advocate when they’re in hospital- or at out-patients…it all happens so quickly and they don’t understand.
What amazes me most about us Irish people is how we have become so passive about all this ( listen to the language on the radio at the moment about K.Cardiff and the RTE libel case….it’s nobody’s fault, and nobody should be accountable. It takes someone like you to remind us that in certain circumstances, anger is a valid response.
I know people who’ve repatriated after an encounter with our ‘health’ services. I do hope you won’t be another.

Glad to hear you’re feeling better, Clare – it must have been a worrying experience for you.

While I wouldn’t for a second take away from the professional, thorough care and attention given by the vast majority of medical staff, there are huge problems with the public system here in terms of access to tests and treatment. I am so thankful to be in a situation where my family and I have access to private health insurance for serious complaints – I know now that that my dad most likely wouldn’t be with us today if he’d had to rely on public hospitals.

Not everyone is as fortunate, though, and, judging by the rumours surrounding health funding in Budget 2012, the situation is only going to get worse. Scary.

Glad to hear you are okay and that you’ve got reassurance now too. I never bothered with private health insurance when living in the UK as I trusted the NHS but have it here, maybe it is because I’m a parent now but somehow I like the reassurance of knowing we have it. Glad to hear that although it was overcrowded and hectic, you felt that the treatment you received was fairly good.

hi – hope you’re well on the road to recovery by now! my (american) husband ended up in the ER in montreal and i was so grateful for the excellent care he received. had we been somewhere else, i’m not sure he’d still be here today. take care!

We’ve had the converse – a child with chickenpox while visiting Boston. And they might as well have had Ebola, since the US vaccinates against chickenpox and they rarely see it. Anyway, the care in Boston was good – once they’d established that we had travel insurance.

In Ireland the problem in healthcare is two-fold – catastophic waste and mismanagement, and the fact that we want a Scandinavian-quality system but we don’t want to pay for it.

Hmmm. As a nurse in an Irish, public, teaching hospital I’m sad that you didn’t have the best experience. But I’d like to make a few points.

Firstly, with regards to dirt and mess in Irish hospitals it’s an awful fact. I’ve come in early in order to re-clean bits of the area I work in after the cleaners have already cleaned it due to the shabby job that is often done. Most of the cleaners in Irish hospitals are contract cleaners and therefore have little accountability to hospital staff. Bring back the battle axe nuns!! They would never stand for such messing about.

Secondly, the nurse to patient ratio hasn’t changed in the last 30 years. This doesn’t seem like a big deal, but the Irish populaion has gotten sicker and older within that time, which means that the average nurse’s working day is a lot harder and busier, and priorities with regard to patient care change. I worked in A and E for a time. Some days I would have up to 15 acutely ill patients, and no extra staff in sight. That’s just not safe and a bit soul destroying, as there is no way to physically give the level of care your patients deserve. Generally no extra staff would be provided by management for fear “the budget” would be exceeded.

With regards to the mix up with your tests, that’s just not excusable. I would hope that human error (due to excessive work load or tiredness) may have been the cause rather than pure lazyness.

Access to private facilities is great. However, most private hospitals are not equipped to deal with emergencies, complex or extremely acutely ill patients.

Very sorry to hear about your experience and hope you are on the mend. Your post comes at an interesting time. I had just read the Irish Times piece a reporter did on 24 hours in the Limerick AE (wish I could find the link but it seems their search button leaves something to be desired), and we have been trying for our 2.5 months here to decide whether or not to get private insurance. We have two children, my husband has a history of cancer, and everyone has different opinions over how much private insurance helps–e.g., cutting waiting time in the AE, no; cutting wait time to get a consultation with a specialist, yes. Very confusing, especially because while our care in the US is astronomically high, (and I remember a few scary freelance writing years “skipping” insurance), we are used to a high standard of care. However, to give any of you Irish readers a sense of the cost for that, if my husband’s guild did not pay for it and we had to pay for it ourselves it would cost $24,000/year for a family of four (and we would still have co-payments, etc.) Anyway, thanks for sharing your perspective.